Evaluation of the accuracy of objective diagnostic modalities for chronic rhinosinusitis and their comparison to each other to reach the correct diagnosis with minimum cost and highest accuracy. Prospective diagnostic cohort study. Academic medical center. Subjects more than 10 years of age presenting for evaluation of chronic rhinosinusitis, not responding to 12 weeks of medical treatment, suffering from at least 2 or more of the following symptoms- nasal obstruction, anterior and or posterior nasal discharge, headache or facial pains, and abnormalities of smell were prospectively studied. All selected patients were subjected to nasal endoscopy and CT paranasal sinuses. Endoscopic findings were scored according to Lund Kennedy scoring system. Sinus CT scans were scored with the Lund Mackay scoring system. The clinical diagnosis of CRS was determined on the basis of the published adult sinusitis guideline criteria and nasal endoscopic findings were compared with the diagnostic gold standard CT. A total of 100 patients were studied. Endoscopy was able to diagnose 87 % as CRS based on Lund-Kennedy score ≥2. 93 % patients could be labeled as CRS based on Lund-Mackey score ≥4. On correlating endoscopy and CT PNS it was found that sensitivity was 88.04 %, specificity was 28.57 %, PPV was 94.19 %, NPV was 15.38 %. Positive likelihood ratio of 1.23 and negative likelihood ratio of 0.42 was found p value was found to be 0.10565, thereby confirming that there is no significant difference in diagnosing CRS by either modality. The addition of nasal endoscopy helps reduce the use of CT, reducing costs and radiation exposure.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Hearing is necessary to learn language, speech and to develop cognitive skills. Hearing helps in developing child to learn, recognize sounds, identify objects, events and internalize concepts. Effects of hearing loss on the development of child’s ability to learn, to communicate and to socialize can be devastating. The study is planned with the aim to study clinical profile of deaf mute children and to identify ‘socio-demographic’ and ‘health’ profile of deaf mute children. This study shows distribution of various socio-demographic factors in deaf mute children and to study their clinical profile. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present cross sectional descriptive study was conducted at OPD of ENT department, Government Medical College and Hospital, Akola, Maharashtra. Study was carried out for a period of two months, it’s included Deaf mute children from 2-12 years of age. 50 subjects were reported over the study of 2 months. For data collection demographic parameters, complete birth history including prenatal, perinatal and postnatal history was noted. Thorough clinical examination was carried out with special attention to branchial arch system. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">There were 70% males compared to 30% females. Male: female ratio was 2.33: 1. Pneumonia (10%) and hyperbilirubinemia (10%) was the commonest health problem. In the study deafness were attributed to 38% genetic causes, 28% Non-genetic and idiopathic in 34% of children. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The age at detection of hearing loss is 0-2 yrs age at which if rehabilitation is done can benefit the child to the maximum. Delayed diagnosis of hearing loss can be explained on basis of community practices of neglecting delayed speech, lack of social awareness and partly due to absence of any active health surveillance in this aspect. Multistep protocol for hearing assessment and parental awareness about facilities of rehabilitation and accessibility of services should be emphasized.</span></p>
<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>
This study was aimed to evaluate surgical outcome of patients undergoing obliteration of mastoid cavity with postauricular composite osteo-periosteal flap. This interventional study was carried out on 100 patients having unsafe CSOM from Nov. 2012 to Oct. 2014 who underwent canal wall down mastoidectomy with tympanoplasty and obliteration of cavity using composite osteo-periosteal flap. The primary outcome measure was control of suppuration and creation of dry, low-maintenance mastoid cavity, which was assessed using Merchant et al. grading system. At the end of 1 year follow-up, 89% patients had Grade 0 summary score while Grade 3 which was considered as failure of control of infection was not obtained in any patient during the entire follow-up period. Mastoid cavity obliteration using composite osteo-periosteal flap is an effective technique to avoid cavity problems.
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